NICOLE AVILEZ (NPI# 1316455850) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316455850 |
| Entity Type | Individual |
| Full Name | NICOLE AVILEZ |
| Other Name | NICOLE WAUGH |
| Credential | PA-C |
| Practice Address |
115 W Bridge Ave Blackwell OK 74631-2800 |
| Mailing Address |
8314 Timber Creek Trl Stillwater OK 74074-5052 |
| Practice Telephone | 5803633501 |
| Mailing Telephone | 8169169153 |
| Enumeration Date | 2018-01-18 |
| Last Update Date | 2018-01-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | 2834 | OK | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
115 W BRIDGE AVE |
| City | BLACKWELL |
| State | OK |
| Zip Code | 74631-2800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114923489 | Jeffrey Robert Shuart | Family Medicine | 115 W Bridge Ave, Blackwell, OK 74631-2800 | 2005-06-22 |
| 1821505199 | Jordan Shuart | Physician Assistant | 115 W Bridge Ave, Blackwell, OK 74631-2800 | 2018-01-08 |
| 1972638773 | Jeffrey R Shuart Md PC | Family Medicine | 115 W Bridge Ave, Blackwell, OK 74631-2800 | 2007-02-22 |
| 1245210954 | Luther Wayne Ghormley | General Practice | 115 W Bridge Ave, Osler Clinic, Blackwell, OK 74631 | 2006-01-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205370194 | Northern Oklahoma Dental Associates Pllc | Clinic/Center | 427 W Doolin Ave, Blackwell, OK 74631 | 2016-12-12 |
| 1184799629 | Ronald Lee Matheson | Registered Nurse | 710 So 13th, Blackwell, OK 74631 | 2006-11-21 |
| 1750300992 | Christopher Ray Chenoweth | Optometrist | 202 E Blackwell, Blackwell, OK 74631 | 2006-07-19 |
| 1518983816 | Nita L Calvin | Physician Assistant | 710 S 13th, Blackwell, OK 74631 | 2006-07-14 |
| 1548629579 | Blackwell Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 119 N Main St, Blackwell, OK 74631 | 2016-02-18 |
| 1255355723 | Triad Medical Inc | Durable Medical Equipment & Medical Supplies | 117 N Main, Blackwell, OK 74631-0854 | 2006-07-27 |
| 1255602355 | Blackwell Hmpn, LLC | Family Medicine | 1005 W Doolin Ave, Blackwell, OK 74631-1350 | 2012-01-20 |
| 1821526468 | Kay County Oklahoma Hospital Company LLC | Family Medicine | 1005 W Doolin Ave, Blackwell, OK 74631-1350 | 2017-05-26 |
| 1932634573 | Kay County Oklahoma Hospital Company LLC | Clinic/Center | 1005 W Doolin Ave, Blackwell, OK 74631-1350 | 2017-04-20 |
| 1710233416 | Blackwell Hmpn, LLC | Surgery | 1005 W Doolin Ave, Blackwell, OK 74631-1350 | 2012-07-31 |
| Find all providers in zip 74631 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821505199 | Jordan Shuart | Physician Assistant | 115 W Bridge Ave, Blackwell, OK 74631-2800 | 2018-01-08 |
| 1275959314 | Kelsey Burnett | Physician Assistant | 1009 W Ferguson Ave, Blackwell, OK 74631-5602 | 2014-03-13 |
| 1700132404 | Blackwell Hmpn, LLC | Physician Assistant | 710 S 13th St, Blackwell, OK 74631-3700 | 2012-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194326496 | Courtland Henderson | Physician Assistant | 2614 Wagon Trl, Enid, OK 73703-1630 | 2020-11-03 |
| 1013517168 | Madeleine Hill | Physician Assistant | 5304 N Hudson Ave, Oklahoma City, OK 73118-6232 | 2020-10-28 |
| 1851990097 | Lauren Heim | Physician Assistant | 7324 Bucks Xing, Edmond, OK 73034-3520 | 2020-10-19 |
| 1003414673 | Stephanie Ann Stephens | Physician Assistant | 5021 Eric Dr, Oklahoma City, OK 73135-4129 | 2020-10-15 |
| 1508464355 | Lauren Danielle Ukleya | Physician Assistant | 1315 Chisholm Trail Pkwy Ste A, Duncan, OK 73533-1544 | 2020-10-14 |
| 1598362964 | Madison Kitchens | Physician Assistant | 471688 Ok-51, Stilwell, OK 74960 | 2020-10-07 |
| 1689271041 | Maissa Baker Mitwalli | Physician Assistant | 700 S Desert Palm Ave, Broken Arrow, OK 74012-8815 | 2020-10-07 |
| 1730705229 | Jenna Specht | Physician Assistant | 2501 N 14th St, Ponca City, OK 74601-1734 | 2020-06-19 |
| 1477176147 | April Dawn Sullivan | Physician Assistant | 1111 Walnut Dr, Ardmore, OK 73401-2354 | 2020-05-28 |
| 1497384754 | Leah Cannady Hester | Physician Assistant | 3145 Midland Valley St, Norman, OK 73069-6970 | 2020-04-07 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.